Provider Demographics
NPI:1033752878
Name:LANCE, SHARON MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:LANCE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:LANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:401 W WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:SAN SABA
Mailing Address - State:TX
Mailing Address - Zip Code:76877-4433
Mailing Address - Country:US
Mailing Address - Phone:325-372-3033
Mailing Address - Fax:325-372-5961
Practice Address - Street 1:401 W WALLACE ST
Practice Address - Street 2:
Practice Address - City:SAN SABA
Practice Address - State:TX
Practice Address - Zip Code:76877-4433
Practice Address - Country:US
Practice Address - Phone:325-372-3033
Practice Address - Fax:325-372-5961
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist